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BEACON PRIMARY CARE LLC
NPI 1417772849
Family Medicine in Fairlawn, OH

Active since November 20, 2024CLIA 36D1100799 · Waiver
3009 SMITH RD STE 350, FAIRLAWN, OH 44333(330) 665-4488(330) 665-4489 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Beacon Primary Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEACON PRIMARY CARE LLC (NPI 1417772849) is a healthcare organization registered as a family medicine in Fairlawn, Ohio and active in the NPI registry since November 2024. The organization holds a CLIA Waiver certificate valid through February 10, 2028 and lists Jennifer L Wurst, Physician/owner, as its authorized official.

NPPES Registry Identity

NPI1417772849
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEACON PRIMARY CARE LLC
Location Address3009 SMITH RD STE 350Fairlawn, OH 44333-2670
Mailing Address3009 Smith Rd Ste 350Fairlawn, OH 44333-2670 · (330) 665-4488 · Fax (330) 665-4489
Phone(330) 665-4488
Fax(330) 665-4489
Organization SubpartNo
Authorized OfficialJennifer L WurstPhysician/owner · (216) 224-3052
Enumeration DateNovember 20, 2024
NPPES CertifiedNovember 20, 2024
✔ NPI 1417772849 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3009 SMITH RD STE 350, Fairlawn, OH 44333
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Beacon Primary Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Beacon Primary Care LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Jennifer Wurst, MD
Family Practice
NPI 1275510166
3009 SMITH RD STE 350
Fairlawn, OH 44333
(330) 665-4488
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 36D1100799

Beacon Primary Care · Fairlawn, OH
Active · expires Feb 10, 2028
CLIA Number36D1100799
Laboratory TypePhysician Office
Certificate Effective DateFebruary 11, 2026
Certificate Expiration DateFebruary 10, 2028
Laboratory DirectorJennifer Wurst
Laboratory Phone(330) 665-4488
Laboratory LocationBeacon Primary Care3009 Smith Rd, #350, Fairlawn, OH 44333
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beacon Primary Care LLC's NPI number?

The NPI number for Beacon Primary Care LLC is 1417772849. It was assigned to this organization in the NPPES registry on November 20, 2024.

Where is Beacon Primary Care LLC located?

Beacon Primary Care LLC is located at 3009 Smith Rd Ste 350, Fairlawn, OH 44333. The listed phone number is (330) 665-4488.

What is Beacon Primary Care LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Beacon Primary Care LLC enrolled in Medicare?

Yes. Beacon Primary Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Beacon Primary Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Beacon Primary Care LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Beacon Primary Care LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 36D1100799) is associated with this NPI, valid through February 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Beacon Primary Care LLC was last updated on November 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.